The UCSD/San Diego Resuscitation Research Center (USRRC) is a regional research network which performs resuscitation research in cardiac arrest and trauma. San Diego County is bordered by a military preserve (Camp Pendleton) to the North, Mexico to the South, the dessert to the East and the Pacific Ocean to the West. This clinical resuscitation research network integrates pre-hospital care, receiving trauma centers, and receiving hospitals for cardiac arrest into an organized network to allow population based pre-hospital research. The USRRC is designed with critical EMS and trauma center leadership, resources to train paramedics in protocol implementation, and a data system to track patient entry and patient follow up. The data system can be modified to accommodate research questions and additional data acquisition as protocols and research questions change. A Clinical Research Skills Development Core is proposed and is supplemented by an existing Clinical Research Training Program at UCSD. Together these will provide a rich opportunity to enhance training in prehospital clinical research for postgraduate MD fellows and young faculty in surgery, emergency medicine or cardiology. The center proposes a trauma trial that will evaluate hypertonic saline/dextran (HDS) as a prehospital resuscitation fluid for hemorrhagic shock in patients following injury. It is expected that this will alter the incidence of multiple organ failure and the mortality associated with multiple organ failure (MOF) by modulating the over-stimulated inflammatory system which follows hemorrhagic shock in injured patients. MOF remains the late cause of death following trauma. A second trial for patients following cardiac arrest evaluates the importance of cardiopulmonary resuscitation (CPR) in patients who are found down for more than 4 minutes following ventricular fibrillation. It is thought that CPR prior to defibrillation may improve outcomes for patients following cardiac arrest with down times greater than four minutes. There are adequate patients in San Diego County to complete these trials in approximately three years.